Non-neoplastic Polyps Flashcards

1
Q

Describe the epidemiology of non-neoplastic polyps.

A
  • Prevalence >60y: 30-40%
  • Men 1.5:1 female RR
  • High risk adenoma development associated with >3 polyps at previous colonoscopy
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2
Q

What is FAP?

A
  • Autosomal dominant condition caused by germline APC gene mutations.
  • 100-1000s colorectal adenomas
  • 100% risk for CRC at 40 w/o colectomy
  • May have extra intestinal manifestations
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3
Q

What are the extracolonic features of FAP?

A

-Duodenal and periampullary neoplasia
-Desmoids
-Congenital hypertrophy of the retinal pigment epithelium (CHRPE)
-Osteomas
-Fibromas
-Epidermoid cysts
(FAP + last 3 = Gardner’s syndrome)

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4
Q

How are adenomatous polyps classified histologically?

A

Tubular, villous, tubulovillous

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5
Q

Why is important to identify adenomatous polyps?

A

Premalignant lesion; exposure of its surface to faecal stream may initiate development of adenocarcinoma.

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6
Q

Management of adenomatous polyp finding?

A
  • Colonoscopy: complete examination of large bowel
  • Remove all lesions
  • Lifelong surveillance
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7
Q

What is Peutz-Jegher’s syndrome?

A

PJS rare, autosomal dominant disorder with hamartomatous polyposis from mutation in STK11 gene.
Fx: mucocutaneous pigmentation and GIT polyposis. Cancer risk = 90% lifetime.

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8
Q

Describe the pathophysiology of polyp development.

A

Proliferation in polyp not limited to base of tubules and differentiation of cells absent > dysplasia.
Adenoma ->carcinoma sequence with double hit deactivation of APC genes, accumulation of mutations (p53, K-ras).

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9
Q

What are the classifications of neoplastic polyps?

A
  • Adenomas (most common)
  • Polypoid adenocarcinomas
  • Lipomas, leiomyomas, lymphomatous polyps
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10
Q

What are the classifications of non-neoplastic polyps?

A
  • Hyperplastic polyps
  • Inflammatory polyps (e.g. UC/CD)
  • Lymphoid polyps, hamartomas
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11
Q

What are the RFx for polyps?

A
  • increasing age
  • FHx
  • previous history of polyps
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